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This is to certify that the certificate hereunto attached is a true and accurate copy of the original
death record on file with the Division of Vital Records, and that Frank Yeropoli, whose name is
subscribed thereto, was at the time of subscribing the same and now is Director, Division of Vital
Records of the Department of Health, for the Commonwealth of Pennsylvania, duly appointed
and commissioned as directed by Act 66 of the General Assembly, approved 29 June 1953, P.L.
304.
AUG 1 ~ 20p7
Date
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PEAMANEI,T ~~~~~~
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Fran eropoli, ' ect
Division of Vital Records
P.O. Box 1528
New Castle, PA 16103
COMMONWEALTH OF PENNSYLIMNIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
128644
~ 8E7f SOCIAL SECURRV NUNEFA -- ORE DFDERNIMd.L D•y.Vr) _ _
+• JOHN PETER BUCKHEIT JR
. MALE L 189 -09 - 4390 L!~'~'Br~ ~ F
AGE,l~BN1M•y uNDER,rE.w IRam,Dw~ oREasrrtN awr,rLADE~cA,.w nucsosoE~e„~a.a.a+ra»-:.nmcw.o•dr•wI
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79 ~" -6-1915
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COUNTY OFDERN prr.SORO.TW-OF OERR„ NAMEQM,irRi•n. O"•e11M •oe ~i OFMSPNIIC OtEOIN1 RACE-AI•wk7•I,IdMI,Ory,,M+I•.•t
CUMBERLAND ~ E. PENNSBORO TWP ~cf Stir,-~ f{S~,i i4; / ~~^~ ~"~"'
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RENEII's NAME Fnr. MiOy, Lry
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JOHN P. BUCKHEIT SR,
, MINNIE HI EY
p+oRMANPSNIWE(!svA•I~r
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SEL4•LCiyWr~9lr, BpCoey
ROBERT BUCKHEIT
14 W. SIMPSON STREET MECHANICSBURG PA
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REGISTRAR'S SIGNgIJ~E AND
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---_----------____. _ Register of bills for the
--------___-- _____- a~~cPase~'. County of ..}r;.tml:ari~nrl_.__ in the '
,. ^ct~t t~..,:,°; r£,~ i,': 's t;_~?_~s~.~~.~1 CormonLVe-<t;th of Pennsylvania
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st. *.r rcevane cir~umstarccs, e.g. renunciation, death of rxecvtor, etc.)
.#~.:C;:i~7':ic^.:1.t `, ,.:ti F:iJC21CilC~ at deal!? lit --~,~. ~k~ COllnty, '~'enY.lSyiYaYUa, :iritll
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(?isi street, nuR~ber znd munci~a~~ty) ''
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~•.::;, de?t, i~~en i 9 years of a$e, cied __~?.~~I"a~'.~t~~ 1994 , l9
.xce^~ as ~o'.'.:>>>vs, cecec?.erat slid not marry, '.vas not divorced and d.id not have a child born or adopted
after e~:ecu°.ic;n c.` t}!e ~:~'aii offered for probate; vas net the victim of a killing and was never adjudicated
;~~ c~ ~ per ti. ~~~ a~;h•.?~ pro~rty with estimated values as follows: ~
'IA ari:.::c.,ec. , ? .~ ,?.} r 11 person^1 property ~ c'~5Q. ~}Q
£; ~ _;. C;=~,r_ic:'c7 i? ~-`.~~.) Personal property in Pennsylvaria ~__ (~,~'A
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~' J ~ :tines{:;l respes;tfully Pst s he probate of the last will and codicil(s)
~ ~1 '-, ..~i: ~ :;h r* -fill of letter ~~~'~lr~~n~ar
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Z';• r~~ ~E~7~SS ~?I~ERE,e~F, I have hereunto set r~iy ;nand to Chic my I
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`'t: ti?Uf~f3 P. BUCY.HEIT and U~~.~i~!/r~ L . L~~~ ~~~~'(;e .c:~ , and
.,~'~..,~.e^{:;: __1-. i.:=~,,~. ~;~ ~;~ , the testator and t e witnesses
rejpcct~.v~~ly, ;hose names are signed to the attached or
{or~~~c~iag instrument, being first duly sworn, do hereby declare
tc~ the undersigned .authority that the testator signed and
exccuted the instrument as his last will and that he had
sa.gned willingly, and that he executed it as his free and
voluntary uct far the purposes therein expressed, and that each
of ~.~.~ ~~=:~?:nesses, in the presence and hearing of the testator,
signed c_he *i~ili as witness and that to the bees. of their
t;~.Q`,a1e~.~e the testator was at that time eighteen years of age
cr nld~r, of sound Hind and under no constraint or- undue
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lei-L1~..~iG!/~7 ~ ~._-/~K7/
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Subscribed and sworn to and acknowledged before me by 30HN P.
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